Erythrocyte sedimentation rate as an independent prognostic factor in mycosis fungoides

Prognostic factors of patients with mycosis fungoides

Introduction

Mycosis fungoides (MF) is the most common type of primary cutaneous T-cell lymphoma. Prognostic factors may help to evaluate the course of the disease and may also be useful in selecting appropriate treatment plans for patients.

Aim

To investigate the potential prognostic factors of MF and their correlations with MF stage.

Material and methods

We evaluated the records of patients with MF who were followed in our lymphoma clinic between 1998 and 2015. Age, sex, disease stage, peripheral blood eosinophilia, eosinophil cationic protein, serum total IgE, lactate dehydrogenase (LDH), and β₂-microglobulin levels were investigated and recorded at the time of diagnosis.

Results

There was a statistically significant positive correlation between high β₂-microglobulin levels and the advanced stage of disease (p < 0.001). The older group of patients had statistically significantly higher levels of β₂-microglobulin compared to the younger group (p = 0.001). We found strong, significantly positive correlations between disease stage and β₂-microglobulin, LDH, and total IgE levels (p < 0.001, rho = 0.335; p = 0.001, r = 0.302; p = 0.001, r = 0.311, respectively). Additionally, there were significantly positive correlations between LDH levels and β₂-microglobulin, total IgE levels (p < 0.001, rho = 0.484; p = 0.001, r = 0.212, respectively). Study limitations: A limited number of patients and the retrospective nature of the study.

Conclusions

We found that β₂-microglobulin was a significant prognostic factor in our study population of MF patients. Also, elevated LDH, β₂-microglobulin, and total IgE levels were correlated with advanced disease. Thus, these parameters can be used together to identify patients who have progressed to the later stages of the disease and who require more aggressive treatment.

Inflammation marker ESR is effective in predicting outcome of diffuse large B-cell lymphoma

Background

Systemic inflammation has been implicated in cancer development and progression. This study examined the best cutoff value of erythrocyte sedimentation rate (ESR) in diffuse large B-cell lymphoma (DLBCL) patients.

Methods

The relationship between ESR and clinical characteristics was analyzed in 182 DLBCL patients from 2006 to 2017. The log-rank test, univariate analysis, and Cox regression analysis were applied to evaluate the relationship between ESR and survival. An ESR of more than 37.5 mm/hour was found to be the optimal threshold value for predicting prognosis.

Results

ESR was associated with more frequent advanced Ann Arbor stage, poorer performance status, elevated lactate dehydrogenase level, the presence of B symptoms, high-risk International Prognostic Index (IPI 3–5), more extranodal involvement (ENI ≥2), non-germinal-center B-cell (non-GCB) subtypes, and more frequent Myc protein positivity. Shorter overall survival (OS) and progression-free survival (PFS) were found for patients with higher ESRs. Multivariate analysis demonstrated that ESR level is an independent prognostic factor of both OS and PFS. In addition, dynamic changes in ESR are valuable in assessing curative effect and predicting disease recurrence.

Conclusion

High ESR in DLBCL patients indicated unfavorable prognosis that may require alternative treatment regimens.

Electronic supplementary material

The online version of this article (10.1186/s12885-018-4914-4) contains supplementary material, which is available to authorized users.

Cutaneous lymphomas

Primary cutaneous lymphomas are extranodal non-Hodgkin lymphomas. They are classified into the two main groups of primary cutaneous T- and B-cell lymphomas. Very rare cases are derived from NK or plasmacytoid dendritic cells. The annual incidence is 1/100,000. Two-thirds of the patients have primary cutaneous T-cell lymphoma, and the remaining one-third have primary cutaneous B-cell lymphoma. Over the years, tremendous progress has been made regarding the diagnostics and classification of cutaneous lymphomas. An exact classification of cutaneous lymphomas is of great importance for the patient, because the different skin lymphomas have very different prognoses and require different therapeutic regimens. The basis for making a diagnosis is a clinical-pathological correlation, including the use of several immunohistochemical markers and molecular biological methods. Treatment of cutaneous lymphoma is adapted to the type of lymphoma and disease stage. First-line therapy consists of treatments that target the skin. Systemic treatment is used in advanced disease. Many targeted therapies have been introduced into routine clinical care in recent years. This review presents an up-to-date approach to the diagnosis and treatment of primary cutaneous lymphomas.